>Let's say this was a hypothyroid person and
>the hiatus was of 1 week, 3 weeks, or 8 weeks.
>
>Of course, this process would be supervised
>by a health care provider, as always.
>
>What would you expect, or what have you
>experienced, when going back on thyroid
>medication after a period of none?

This seems to be the week for lurkers to step out into the list.
The longer 8 week period you asked about would probably be similar
to the first time folks started taking T4, given that most of the available
T4 would be well out of your system by that time and they might have
started feeling hypo symptoms. In dealing with suddenly going hypo from
Graves & R
AI, I basically ended up going from nothing to a 150 dose over
the course of about 3 weeks. Other people have mentioned their docs being
pretty conservative about increasing their dosage, but since I was in
generally good health other than bad hypo symptoms, the endo I was seeing
let me push the dose upwards as fast as was comfortable for me. I increased
the T4 dose by the available increments (12.5) about every second or third
day.

Downside to ramping up the synthroid dosage quickly was serious headaches
on the first day or two of each increase (dealt with by sleeping a lot,
which I wanted to do anyway, and some ibuprofen), and brief, oddball rashes
with a few of the increases (which I suspected was probably from some of
the different colorants/additives). Working during this period was pretty
much out of the question for me given the severity of my hypo symptoms, but
I think that someone who was
n't experiencing really serious symptoms yet
would be able to manage this kind of stepped dose regimen while still
working, especially if they'd been without meds for the shorter periods of
time you mentioned. Given the life of T4 in our systems, people who only
miss a week or three would probably be able to step up their dose starting
from mid-ranged doses, rather than starting from the bottom up all over
again. People with other medical problems, especially blood pressure or
heart disease, would need to be considerably less aggressive in upping
their dosage.

Luckily, to make my rapid dose increases easier to manage, I was able to
use the free sample doses the manufacturers had given to the doc's
practice. It's nice that the pharmaceutical industry's aggressive marketing
practices can work in our favor sometimes. People that aren't able to pay
for a prescription for a week or two shouldn't be shy ab
out asking for
extra samples from their docs- remember that the meds have a short shelf
life and they get pitched regularly, if not used. If you can't get samples
to help out when you get ready to reestablish your routine, have your
pharmacist issue your prescription in a variety of dosages (adding up to
the same daily total). It will make the pharmacists crazy and you may need
have a stern talk with your insurance company, but this helps a lot if you
want to mix & match your way back to your previous dosage.

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